August 21, 2012
Charity Medical – Problems with State Lines
Even nonprofit medical is stopped at the state line. Even if the doctors in that state will not treat these patients, they will also prevent doctors working for charities from treating these patients, if they are not licensed in that state. How pig headed these doctors have become? They will not treat these patients, and they are damn if they will allow anyone else to treat them.
This is a reason for congressional legislation that would make a doctor given a doctors license to practice medicine in one state, able to practice medicine in any state or US territory. And, no – I am not saying if one state allows a doctor to practice dentistry, that the next state will allow the same doctor to practice oral surgery. This would only happen if the original state allowed both because the doctor qualified for both.
This article in the Tennessean shows what state lines prevent and actions of the medical boards within these states. This is one area, that for the greater good, needs a federal law to allow doctors to cross state lines. With the coming doctor shortage, this will continue to be a problem. Telemedicine is also hamstrung by these same shortsighted medical groups.
I am not a lawyer, but something needs to be done to make it possible for doctors to work across state lines. If nothing more than reciprocity between states and removing the requirement of being physically present to apply to practice and reducing the fee requirement. Maybe a federal register can be maintained of doctors practicing across state lines. This should also apply to nurses, nurse practitioners (NP), and physician assistants (PA).
Over 30 states have the law now that a doctor needs to physically see a patient before a prescription can be written. Read my blog here about this. This may need to be modified to allow for an examination by a nurse, NP (nurse practitioner), or PA (physician assistant) and then a prescription issued by the doctor after a video conference with the nurse, NP, or PA. This might also include a pharmacist. For telemedicine to work, medical groups will need to work together and not cripple ideas that could save lives. As many situations currently exist, doctors are doing harm to patients by preventing them being seen by nurses and others capable of using telemedicine and getting prescriptions to people in need.
If state medical boards and the different medical organizations continue to block and cripple new medical initiatives, the medical community will have no one but themselves to blame when the backlash from the patient community happens. In some rural communities, people are already displeased that doctors cannot use telemedicine to assist them and in others, they are losing their doctors because hospitals either have bought out a medical practice and closed it, or have hired the doctors away to larger cities and bigger hospitals. This means longer travel times for the people in these areas to see a doctor. Some people do not have the resources or ability to travel these distances.